Does Living with Parkinson's Disease Affect Life-Space Mobility? A Multiple-Methods Study
Notice bibliographique
Résumé
BACKGROUND: Parkinson’s disease (PD) is a progressive, neurodegenerative disorder characterized by resting tremors, instability, slowness of movement and rigidity, generally accompanied by non-motor symptoms such as mood disturbance, fatigue, constipation, incontinence and sleep disorders. Any one of these symptoms can affect an individual’s capacity for home and community mobility but does not independently determine mobility performance. The objectives of this multiple-methods study were to identify a diverse set of explanatory factors that contributed to a model life-space mobility in people with PD and determine facilitators and barriers to mobility in a sample of this population. METHODS: We recruited 227 individuals with (n = 113) and without (n = 114) PD, who were comparable in age, from the community to complete a cross-sectional survey regarding mobility. The primary outcome was the life-space mobility composite score (LSA-C), which ranges from 0-120 (University of Alabama Birmingham Life-Space Assessment). Higher LSA-C represents more mobility in the home and community based on the frequency, distance, and independence of trips. Explanatory variables included demographics, lifestyle behaviours, driving status, self-reported health status, social participation and characteristics of the built environment. Descriptive statistics were used to describe and compare patterns of life-space mobility between participants with and without PD. Multivariable linear regression was used to identify factors that explained life-space mobility. Ten participants with PD participated in a semi-structured interview about facilitators and barriers to mobility. Guided by a comprehensive framework for mobility in older adults, transcripts were content analyzed. RESULTS: Mean LSA-C was lower for people with PD (life-space mobility composite score 64.2, SD = 25.8) in comparison to people without PD (70.3, SD=23.1; mean difference = 6 points, 95% CI: -0.4, 12.5). Participants with PD employed assistive mobility devices in higher proportions than participants without PD to reach the same life-space levels. Among people with PD, not driving, receiving caregiving and not having extra money in the house were associated with reduced life-space mobility. Social participation was the only factor associated with increased life-space mobility in the multivariable model. Data from qualitative interviews supported quantitative findings regarding the facilitating influence of driving, having social support and participating in the community. Interviewees identified additional barriers to mobility, which included PD-related anxiety and certain characteristics of the built environment such as being in crowded and confined spaces. CONCLUSIONS: People with PD reach similar levels of life-space compared to their counterparts without PD, but more commonly use an assistive mobility device to do so. We provide evidence that a diverse set of factors related to the individual, and social and built environments are associated with life-space mobility among people with PD. IMPLICATIONS: Clinicians and policy-makers should consider personal, social and environmental factors when developing interventions to improve the life-space mobility of the PD population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».